24 November 2008

The GP bloggers are getting angry about the failure of hospital doctors to issue certificates. They write: This is NOT a rant against my colleagues in secondary care and claim we are ignorant or they imply we are lazy. So which is it? Dr Grumble thinks it is simply because we are provided with the wrong form. Here is the one some of us have been using. It only covers the hospital stay.

Here's a quote from the document linked to below:

Until now the Med 3 statement has been used very rarely in Trusts and in the whole of the NHS generally. There is widespread use of the Med 10.

As far back as 2001, Trusts were required to integrate a simple sickness certification procedure into the hospital discharge and out patient process. The reason was so that hospital doctors and consultants would not refer patients to a GP solely for the purpose of obtaining a sick certificate. At that time, it was estimated that 518,000 appointments per year could be saved for GPs plus 42,000 hours. Also, it would ensure a seamless service for patients upon discharge.

Issue date: September 06[So it has only taken them five years.]

The problem is clear. It's not much to do with laziness. Filling in one form is much the same as filling in another. It makes no odds to Dr Grumble. But in the Trust where Grumble works there are, say, over 1000 inpatients and over 50 wards on more than one site. Getting the right pieces of paper to all these places is a challenge. This is a management failing. It needs a management solution. And it can be done. Filling in forms is a shocking waste of a GP's time and it won't take us any longer. We just need the right piece of paper. That's all.

Posted by
Dr Grumble

8 comments:

Anonymous
said...

carnt even issue prescriptions on the correct one of half a dozen different script forms

why oh why oh why dont we scrap all this nonsense and have ONE prescription form which the patient can take to any dispensary either in the hospital or outside as fits their needs (opening hours etc) best

Well, anon, if we are on to prescriptions, hospital doctors are usually extremely restricted in what sort of form they are permitted to use. Dr Grumble gets a rap over the knuckles if he writes any prescription at all for an outpatient. The reason is that the hospital has to pay for the drugs and the cost can be substantial. But at the end of the day all the money comes out of the same taxpayers' pot so you could well ask: where is patient choice in all of this? It is pretty mad for a patient to come to hospital have a drug recommended and then have to go to their GP for a prescription. This must create many more unnecessary appointments and time wasted than the sick certification issue but it's been such a long-standing problem that nobody even notices any more.

this is undoubedly a pain and, particularly for the post op patient, it would help enourmously if the hospital would issue a certificate.

So if, for example, a patient has had an AP resection, a cert. from the hospital for, say, six weeks would be helpful.

I hesitate to suggest the following, but why on earth could a nurse not be allowed to issue the correct certificate. There could be a protocol tariff for each operation, and then the certificate nurse specialist could sign it.

The strength of the certificate most often used is that 'any authorised person' can fill it in. Perhaps that is the reason we use it.

But, as Dame Carol has pointed out, signing somebody off from work is a serious issue and it is not at all clear to Dr G that any old 'kind-hearted' authorised person signing somebody with back pain off for a long period is necessarily a good idea.

Dr G has lots of patients with chronic back pain who live on benefit. He has never signed a single one of them off. For many of them he cannot understand why they cannot work. Living on benefit appears to have led to a spiral of miserable decline for these poor people.